Identifying cancer in dense breast tissue

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Published: 3 May 2017
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Cheryl Cruwys - Breast Density Matters UK

Cheryl Cruwys speaks with ecancer at the 1st Cancer Research @ Bath Symposium about the diagnostic considerations required for identifying cancer in a patient with dense breast tissue.

Cheryl's 8mm invasive tumour was detected early by French clinicians, and she has since striven to promote awareness by doctors and concerned women of how to identify cancer in dense breasts.

For more information from Dense Breast Matters, click here.

Read Cheryl's editorial on dense breast screening here.

My name is Cheryl Cruwys and I am co-founder of Breast Density Matters UK which is a breast cancer patient advocacy. I am attending the Cancer Symposium at Bath University today to educate and share information on breast density and to talk about why breast density matters.
Last year, following my 50th birthday, I received an invitation for a mammogram. I have no family history of cancer, nor did I have any symptoms. I was immediately informed that the mammogram was clear. However, the radiologist insisted that I had a supplemental ultrasound which detected a small shadow and the subsequent biopsy confirmed an 8mm invasive cancerous tumour. My treatment was minimal – a lumpectomy, an operation to remove the tumour, and radiotherapy; no mastectomy, no chemotherapy nor metastatic cancer.
I decided to educate myself and I discovered that breasts are made up of fatty tissue and dense tissue, glandular tissue. Dense breasts are normal. 40% of women aged forty and over have dense breasts. A mammogram detects a woman’s breast density but women are not informed of this. Density is not a constant so it can change with age. The issue with dense breasts is that whilst a mammogram may detect cancers in fatty breasts they are not as effective for detecting cancers in dense breasts. So on a mammogram image cancer appears white but so does dense tissue. Basically it is like looking for a snowball in a snowstorm. Women with dense breasts should be referred for further screening.
So some statistics: up to 50% of breast cancers go undetected in women with dense breasts. In the UK up to 3,500 breast cancers go undetected each year. Dense tissue is a strong predictor for developing breast cancer – the denser the breasts the greater the risks. I am not a medical expert, however Breast Density Matters UK is supported by medical professionals from the UK and worldwide, breast surgeons, radiologists, scientists as well as breast cancer patients from Canada, Australia, Argentina and the USA. In the USA thirty US states have now introduced legislation to inform women of their breast density and that a mammogram alone may not be sufficient. Also, breast density is not breaking news. In France supplemental ultrasound has been coupled with mammography for many years. What is new is that scientists are now stepping up and talking about it, especially in Australia where scientists and researchers hold public forums as they believe women need to be informed.
A couple of final points: we have launched a petition to the UK government. So if you would like to sign and support the campaign do get in touch. Our advice to women is knowledge is power so educate yourself on density. Be breast aware – touch, look and check your breasts regularly and if you have any concerns visit your GP and be assertive for a breast referral.
Some brief acknowledgements and my thanks go to Terri Bainbridge and Lisa Portman, co-founders, and Patricia Copestake, a lead ambassador and breast cancer patient. Indeed, thanks to all our ambassadors who continue to support the campaign.